Noncemented Total Hip Arthroplasty for Osteonecrosis of the Femoral Head in Elderly Patients
Bibliographic record
Abstract
The results of total hip arthroplasty (THA) for osteonecrosis of the femoral head (ONFH) in elderly patients (80 years or older) has not been well defined. The purpose of this retrospective study was to evaluate the clinical course of and the results in noncemented THA for ONFH in elderly patients.Between 1998 and 2007, one hundred seven consecutive hips with ONFH in 103 patients were evaluated. The causes of ONFH were traumatic in 46 (43%) hips and nontraumatic in 61 (57%) hips. All hips were treated with noncemented THA. Average follow-up was 72 months (range, 60-144 months). The functional results improved to statistical significance after THA. However, no significant differences existed between 6 months, 1 year, and 5 years postoperatively. Nine (8.4%) postoperative complications occurred in these 107 hips, including 1 stem loosening, 1 liner wearing, 4 postoperative infections, 2 postoperative dislocations, and 1 pulmonary embolism. Fifteen (14.6%) deaths occurred during follow-up. The progression of ONFH in elderly patients was so rapid and the result of core decompression was so poor that a salvage procedure seemed to have no role in the treatment. Harris Hip Score, Short Form 36 physical function score, and Western Ontario and McMaster Universities Osteoarthritis Index scores significantly improved after noncemented THA. Ninety-two hips had a complete follow-up, and the survivorship of prosthesis was 95% (88/92) with minimal 5-year follow-up. Noncemented THA was effective in the treatment of ONFH in this group of patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".